STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF:
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IN THE PROBATE COURT STATEMENT OF VALUE AND INCOME FOR PURPOSES OF BOND CASE NUMBER:
The undersigned, after being duly sworn, states that: 1. His/her/their best estimate of the value of the personal property of the estate in this matter is $ 2. The income expected during the next year from the personal property in this matter is $ 3. The total of this value and income is $ . . .
4. Of the above amount, $ has been placed in a bank or other financial institution with the appropriate restriction that the funds may not be withdrawn, disbursed, or otherwise distributed without the prior approval of the Probate Court. 5. Should further assets be located at a later date, Personal Representative shall immediately report such finding to the Probate Court and complete a Petition to alter bond (Form 343PC). SWORN to before me this , 20 day of Signature:
Signature: Name: Address: E-mail: Telephone (O): (H):
Notary Public for South Carolina My Commission Expires:
ORDER IT IS HEREBY ORDERED that bond be set at $ Executed this day of . , 20 .
, Probate Court Judge
FORM #340PC (2/2004) 62-3-604, 62-5-411, 62-3-616, 62-7-304